Diseasewiki.com

Home - Disease list page 153

English | 中文 | Русский | Français | Deutsch | Español | Português | عربي | 日本語 | 한국어 | Italiano | Ελληνικά | ภาษาไทย | Tiếng Việt |

Search

Prolapse syndrome of perineum

  The prolapse syndrome of perineum (DPS) is a pelvic floor disease caused by various reasons leading to the变性 of pelvic floor muscles and dysfunction. Patients have a lower perineum in a quiet state or when defecating, and the degree of perineal descent exceeds the normal range, manifesting as出口性便秘 or fecal incontinence in clinical practice. Women are more common than men, multiparous women are more common, and it can occur at any age, but it is rare in those under 30 years old.

 

Table of Contents

1. What are the causes of the prolapse syndrome of perineum?
2. What complications can the prolapse syndrome of perineum easily lead to?
3. What are the typical symptoms of the prolapse syndrome of perineum?
4. How to prevent the prolapse syndrome of perineum?
5. What kind of laboratory tests should be done for the prolapse syndrome of perineum?
6. Dietary taboos for patients with the prolapse syndrome of perineum
7. The conventional method of Western medicine for treating the prolapse syndrome of perineum

1. What are the causes of the prolapse syndrome of perineum?

  The prolapse syndrome of perineum is caused by long-term squatting and excessive forceful defecation, which weakens the function of the pelvic floor muscles, causing the normal anal canal-rectal angle to increase, and promoting the prolapse of the rectal mucosal anterior wall into the anal orifice by the increased intra-abdominal pressure transmitted by the anterior wall mucosal prolapse in a vicious cycle. This anterior wall mucosal prolapse (AMP) can lead to incomplete defecation sensation, and thus, the patients further exert force to defecate, forming a vicious cycle. In addition, multiple deliveries in multiparous women are also prone to this disease.

2. What complications can perineal descent syndrome lead to

  Perineal descent syndrome mainly complicates anal incontinence, which is caused by abnormal descent of the perineum due to childbirth or long-term forceful defecation, causing the stretching injury of the perineal nerves, leading to denervation degeneration and weakening of the pelvic floor striated muscles.

3. What are the typical symptoms of perineal descent syndrome

  Patients with perineal descent syndrome complain of a feeling of rectal obstruction, that is, incomplete defecation, dullness and pain in the perineal area, difficulty in defecation, and sometimes mucous bloody stools. In the late stage, patients may have varying degrees of fecal incontinence and persistent perineal pain, which may occur or worsen when sitting. This is because when the pelvic floor descends, the nerves in the perineal area and their branches that支配the anal external sphincter and levator ani are stretched, and excessive stretching can seriously affect their function, leading to denervation changes in the pelvic floor muscles, making the pelvic floor muscles weaker.

4. How to prevent perineal descent syndrome

  Patients with perineal descent should persist in physical exercise and strengthen the abdominal muscle exercises to improve the condition of Qi and blood deficiency and Qi insufficiency, which is of great practical significance for consolidating the efficacy and preventing rectal prolapse. Specific preventive measures include:
  1. Actively eliminate various triggering factors, such as coughing, prolonged sitting or standing, diarrhea, long-term cough, enteritis, etc., especially pay attention to infants and children.
  2. Pay attention to increasing nutrition and regular life habits, do not sit on the toilet pot for a long time, develop the habit of regular defecation, and prevent constipation. You can take a hot water bath after defecation and before going to bed to stimulate the contraction of the anal sphincter, which has a positive effect on preventing perineal descent.
  3. Patients with habitual constipation or difficulty in defecation should not strain too hard during defecation in addition to eating more fibrous foods.
  4. Women should rest adequately during childbirth and postpartum to protect the normal function of the anal sphincter. Those with uterine prolapse and visceral prolapse should be treated in a timely manner.
  5. Regularly perform anal exercises to promote the movement of the anal muscle group, which has the effect of enhancing the anal sphincter function and can prevent this disease to a certain extent.

5. What kind of laboratory tests are needed for perineal descent syndrome

  There are many examination methods for perineal descent syndrome, mainly the following:
  1. Squatting examination:At rest, the anal canal can be in a normal position or 1.0 cm below the pelvic bony outlet, but when the patient is asked to squat and strain at the anus, the anal canal can descend more than 2.0 cm, even above the ischial tuberosity level.
  2. Rectal examination:The anal canal's expansion force during the resting phase is reduced, and when the patient is asked to voluntarily contract, the anal canal contraction force is significantly weakened.
  3. Anoscopic examination:Visible mucosal堆积 in the anterior rectal wall, blocking the end of the scope.
  4. Anal canal manometry:The resting pressure and maximum contraction pressure of the anal canal can be reduced.
  5. Defecation contrast examination:The static phase shows slight descent of the perineum and a small protrusion of the anterior rectal wall; in the force expulsion phase, the entire perineum descends by 3.5 cm, especially in the posterior part. In addition to showing an abnormally low position of the pelvic floor, other lesions can also be found, such as anterior rectal prolapse.

6. Dietary preferences and taboos for patients with perineal descent syndrome

  Patients with perineal descent syndrome should pay attention to eating more fiber-rich foods such as fresh fruits and vegetables; eat more coarse grains and mixed grains such as brown rice, corn, and whole wheat bread, and eat less refined rice and flour; eat more nutritious dry fruit seeds such as sunflower seeds, sesame seeds, pumpkin seeds, peanuts, walnuts, and raisins. Patients should avoid spicy and刺激性 foods, which can lead to dry stools and worsen the condition.

7. Conventional methods for the treatment of perineal descent syndrome in Western medicine

  The treatment of perineal descent syndrome includes non-surgical treatment and surgical treatment, the specific content is as follows:

  First, Non-surgical Treatment
  1. Develop good defecation habits: Develop a good habit of regular defecation, avoid excessive straining during defecation, and avoid spending too much time on each defecation, which is better not to exceed 10 minutes; fiber preparations can be appropriately used to help defecation, thereby avoiding further damage to the pelvic floor muscles.
  2. Strengthen anal exercises: The function of the pelvic floor muscles is mainly reflected in the contraction and relaxation of the anus. This movement is coordinated by the internal and external anal sphincters, levator ani muscles, and other muscles through complex mechanisms. Exercise methods can be adopted in supine knee position or other positions,配合 breathing and levator ani muscle movement, inhale when the pelvic floor muscles contract and exhale when they relax. This alternating contraction and relaxation is the basic method to alleviate perineal descent and restore the tension of the pelvic floor muscles.
  3. Aggressive treatment of associated lesions: To alleviate symptoms and prevent further injury to the pelvic floor muscles, active treatment of prolapse should be given to patients with perineal descent syndrome accompanied by rectal intussusception or rectal prolapse. The aim is to break the vicious cycle between perineal descent syndrome, excessive straining during defecation, and prolapse. The first line of treatment is injection therapy, followed by strengthening anal exercises, which have been shown to be effective.

  Second, Surgical Treatment
  For those who are ineffective after injection treatment or have rectal intussusception inside the anal canal, surgical correction of rectal intussusception can be performed. However, due to pelvic floor muscle dysfunction associated with perineal descent syndrome, even after transabdominal rectal fixation or suspension surgery, some symptoms may still remain postoperatively.
  Since perineal descent syndrome is accompanied by some degree of pelvic floor muscle dysfunction, clinical physicians should avoid performing anal dilation treatment to prevent further damage to the sphincter muscles and postoperative anal incontinence.

Recommend: Heroin kidney disease , Mixed tubular acidosis , Active cecum syndrome , Perineal hernia , Pyogenic pelvic thrombophlebitis , Type II renal tubular acidosis

<<< Prev Next >>>



Copyright © Diseasewiki.com

Powered by Ce4e.com